URS Verification Pvt. Ltd.

F-3 Sector-6, Noida-201301(U.P.)

Please send this form to mahesh.dave@urs-labs.com or ce@ursindia.com

Application Form
Product Certification

Contact Details:
Company Name Indutch Composite Technology Pvt ltd
Address Waghodiya Industrial Estate, Plot No 187/P/1B-1, Waghodiya Road,
Vadodara
City Vadodara
Contact Person Ritesh Dandale
Contact Number 7046088815
E-mail ritesh.dandale@indutch.in
Product Information:
Product Name FRP Composite mold with heating mechanism
Model / Identification
Serial Number
Electrical Parameters 24 DC, 230 Ac……….V , ………..I, ……….W, ……50……Hz, …1 &
3……..Phase
Product Description FRP composite mould with electric heating panels ( PLC/PID/SCADA base
with Application control system)
Applicable Standards
Certification CE CB G-Mark CoC Type Approval SASO
Requirement
Brief Operating
Procedure

Detailed Specifications:
Size (in inches) 800”H 600”W 400”D
Weight (in Kgs)
Product type Electrical
(Electrical/Electronic)
Maximum Internal 50/60 Hz
operating frequency
Electrical Power Voltage Type: DC AC DC+AC Battery Solar Others
Supply
Please specify if
others:_____________________________________________
Operating Voltage :
Multiple Voltage Range:
Current (Max) :

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 Power Consumption (Max loaded) :
Short Circuit Rating of Control Panel:
How EUT is mounted Table top Rack mount Floor standing Other (describe)

The EUT will be Residential Industrial

located in the
Other (Hospitals, Laboratories and Medical Institution)
following locations
(check all that apply)
The environmental Class A
classification of the (equipment intended to be located in a commercial/industrial environment)
EUT is Class B
(check all that apply) (equipment intended to be located in a domestic/residential environment)

Signal/Control lines
with length
Does the product has Yes No
Wireless Features (No need to fill this section if NO Wireless features in the product)
If Yes Please provide Details

If yes provide detail

Additional Information:
Hydraulic System
Specifications
Pneumatic System Valve Cylinders, Pressure Transmitters
Specifications
List of Safety Critical
components
(Transformers, Relay, Chokes,
Cables, etc.)
List of Safety Components used
(i.e. E Stops, Limit Switches,
Light Curtains etc.)
Product Photograph:

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 For EMC Requirements: Fill up wherever Applicable.
TEST NAME STANDARD ON MAINS ON I/O LINE TEST TO BE PERFORMANCE
LINE (TEST CONDUCTED CRITERIA
LEVEL &
(TEST (YES/NO)
FREQUENCY
LEVEL &
RANGE)
FREQUENCY
RANGE)
Electric Fast Transient IEC 61000-4-4 Yes
(EFT)
Electromagnetic High IEC 61000-4-3 Yes
freq. fields Immunity
test
Electro Static Discharge IEC 61000-4-2 Yes
test: ESD
Immunity to conducted IEC 61000-4-6 Yes
disturbances induced by
RF fields
Conducted Emission CISPR 22/11

Radiated Emission CISPR 22/11 Yes

Surge Immunity Test IEC 61000-4-5 Yes

Voltage Dips & IEC 61000-4-11 Yes

Interruption (Only AC
Dips)* (Continuous
current rating of 2 amp
and inrush of maximum
current 18 amp )
Power Frequency IEC 61000-4-8
Magnetic Field
Any Additional Test
Required
Acceptance criteria /Performance specification of product
Performance Criteria A: Details to be provided by customer and as per standard
Performance Criteria B: Details to be provided by customer and as per standard
Performance Criteria C: Details to be provided by customer and as per standard
Performance Criteria D: Details to be provided by customer and as per standard

NOTE: You may use separate sheet for any additional information you would like to mention.
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